How much rates vary
Distribution of negotiated rates across all payers (price axis is log-scale). Need provider-level prices or 24+ months of history? Contact us.
Rates by insurance carrier
| Insurance Carrier | Facility/Professional | Modifier | Typical Low | Median | Typical High |
|---|---|---|---|---|---|
Aetna Setting Facility Modifier None Typical Low $977.24 Median $3,715.35 Typical High $6,760.83 | Facility | None | $977.24 | $3,715.35 | $6,760.83 |
Aetna Setting Professional Modifier None Typical Low $158.49 Median $1,230.27 Typical High $1,862.09 | Professional | None | $158.49 | $1,230.27 | $1,862.09 |
Ambetter Setting Professional Modifier None Typical Low $1,348.96 Median $1,348.96 Typical High $1,348.96 | Professional | None | $1,348.96 | $1,348.96 | $1,348.96 |
BCBS Arizona Setting Facility Modifier None Typical Low $43.65 Median $104.71 Typical High $275.42 | Facility | None | $43.65 | $104.71 | $275.42 |
BCBS Arizona Setting Professional Modifier None Typical Low $134.90 Median $954.99 Typical High $1,862.09 | Professional | None | $134.90 | $954.99 | $1,862.09 |
Cigna Setting Facility Modifier None Typical Low $1,023.29 Median $1,348.96 Typical High $6,760.83 | Facility | None | $1,023.29 | $1,348.96 | $6,760.83 |
Cigna Setting Professional Modifier None Typical Low $158.49 Median $398.11 Typical High $2,041.74 | Professional | None | $158.49 | $398.11 | $2,041.74 |
Medica Setting Facility Modifier None Typical Low $380.19 Median $954.99 Typical High $3,388.44 | Facility | None | $380.19 | $954.99 | $3,388.44 |
Medica Setting Professional Modifier None Typical Low $1,584.89 Median $4,786.30 Typical High $10,000.00 | Professional | None | $1,584.89 | $4,786.30 | $10,000.00 |
United Setting Facility Modifier None Typical Low $501.19 Median $1,174.90 Typical High $4,897.79 | Facility | None | $501.19 | $1,174.90 | $4,897.79 |
United Setting Professional Modifier None Typical Low $147.91 Median $1,202.26 Typical High $2,290.87 | Professional | None | $147.91 | $1,202.26 | $2,290.87 |
5 more rates with less common billing modifiers
A modifier changes what was billed, for example a reduced or repeated service. Each of these modifiers carries under 10% of the published rates for this code. Modifier combinations, and modifiers with fewer than 30 rates for a carrier, are not listed.
| Insurance Carrier | Facility/Professional | Modifier | Typical Low | Median | Typical High |
|---|---|---|---|---|---|
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $81.28 Median $102.33 Typical High $707.95 | Professional | 52 · Reduced service | $81.28 | $102.33 | $707.95 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $32.36 Median $40.74 Typical High $281.84 | Professional | 53 · Discontinued | $32.36 | $40.74 | $281.84 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $123.03 Median $154.88 Typical High $1,047.13 | Professional | 54 · Surgery only | $123.03 | $154.88 | $1,047.13 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $24.55 Median $30.90 Typical High $208.93 | Professional | 55 · Aftercare only | $24.55 | $30.90 | $208.93 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $16.22 Median $20.42 Typical High $141.25 | Professional | 56 · Pre-op care only | $16.22 | $20.42 | $141.25 |
Where Arizona sits
The same service costs 8.5 times more in Wisconsin than in Nebraska. Every bar is a state, most expensive first. Touch or drag across it to read any state, then open that state for its carriers and full range.
Arizona· 27th of 51
$1,349
Median negotiated rate in each state, from every insurer that publishes one. States where no insurer publishes a rate for this service are not shown.